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Acute respiratory failure in patients with hematological malignancies : outcomes according to initial ventilation strategy : a Groupe de recherche respiratoire en réanimation onco-hématologique (Grrr-OH) study

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Abstract
Background: In patients with hematological malignancies and acute respiratory failure (ARF), noninvasive ventilation was associated with a decreased mortality in older studies. However, mortality of intubated patients decreased in the last years. In this study, we assess outcomes in those patients according to the initial ventilation strategy. Methods: We performed a post hoc analysis of a prospective multicentre study of critically ill hematology patients, in 17 intensive care units in France and Belgium. Patients with hematological malignancies admitted for ARF in 2010 and 2011 and who were not intubated at admission were included in the study. A propensity score-based approach was used to assess the impact of NIV compared to oxygen only on hospital mortality. Results: Among 1011 patients admitted to ICU during the study period, 380 met inclusion criteria. Underlying diseases included lymphoid (n = 162, 42.6 %) or myeloid (n = 141, 37.1 %) diseases. ARF etiologies were pulmonary infections (n = 161, 43 %), malignant infiltration (n = 65, 17 %) or cardiac pulmonary edema (n = 40, 10 %). Mechanical ventilation was ultimately needed in 94 (24.7 %) patients, within 3 [2-5] days of ICU admission. Hospital mortality was 32 % (123 deaths). At ICU admission, 142 patients received first-line noninvasive ventilation (NIV), whereas 238 received oxygen only. Fifty-five patients in each group (NIV or oxygen only) were matched according the propensity score. NIV was not associated with decreased hospital mortality [OR 1.5 (0.62-3.65)]. Conclusions: In hematology patients with acute respiratory failure, initial treatment with NIV did not improve survival compared to oxygen only.
Keywords
Lymphoma, Noninvasive ventilation, Immunosuppression, ICU, PROGNOSTIC-FACTORS, SURVIVAL, CANCER-PATIENTS, PROSPECTIVE MULTICENTER, Leukemia, PROPENSITY SCORE METHODS, ACUTE MYELOID-LEUKEMIA, Mechanical ventilation, INTENSIVE-CARE-UNIT, NONINVASIVE MECHANICAL VENTILATION, RANDOMIZED CONTROLLED-TRIAL, Neutropenia

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MLA
Lemiale, Virginie, Matthieu Resche-Rigon, Djamel Mokart, et al. “Acute Respiratory Failure in Patients with Hematological Malignancies : Outcomes According to Initial Ventilation Strategy : a Groupe De Recherche Respiratoire En Réanimation Onco-hématologique (Grrr-OH) Study.” ANNALS OF INTENSIVE CARE 5 (2015): n. pag. Print.
APA
Lemiale, V., Resche-Rigon, M., Mokart, D., Pène, F., Rabbat, A., Kouatchet, A., Vincent, F., et al. (2015). Acute respiratory failure in patients with hematological malignancies : outcomes according to initial ventilation strategy : a Groupe de recherche respiratoire en réanimation onco-hématologique (Grrr-OH) study. ANNALS OF INTENSIVE CARE, 5.
Chicago author-date
Lemiale, Virginie, Matthieu Resche-Rigon, Djamel Mokart, Frederic Pène, Antoine Rabbat, Achille Kouatchet, François Vincent, et al. 2015. “Acute Respiratory Failure in Patients with Hematological Malignancies : Outcomes According to Initial Ventilation Strategy : a Groupe De Recherche Respiratoire En Réanimation Onco-hématologique (Grrr-OH) Study.” Annals of Intensive Care 5.
Chicago author-date (all authors)
Lemiale, Virginie, Matthieu Resche-Rigon, Djamel Mokart, Frederic Pène, Antoine Rabbat, Achille Kouatchet, François Vincent, Fabrice Bruneel, Martine Nyunga, Christine Lebert, Pierre Perez, Anne-Pascale Meert, Dominique Benoit, Sylvie Chevret, and Elie Azoulay. 2015. “Acute Respiratory Failure in Patients with Hematological Malignancies : Outcomes According to Initial Ventilation Strategy : a Groupe De Recherche Respiratoire En Réanimation Onco-hématologique (Grrr-OH) Study.” Annals of Intensive Care 5.
Vancouver
1.
Lemiale V, Resche-Rigon M, Mokart D, Pène F, Rabbat A, Kouatchet A, et al. Acute respiratory failure in patients with hematological malignancies : outcomes according to initial ventilation strategy : a Groupe de recherche respiratoire en réanimation onco-hématologique (Grrr-OH) study. ANNALS OF INTENSIVE CARE. 2015;5.
IEEE
[1]
V. Lemiale et al., “Acute respiratory failure in patients with hematological malignancies : outcomes according to initial ventilation strategy : a Groupe de recherche respiratoire en réanimation onco-hématologique (Grrr-OH) study,” ANNALS OF INTENSIVE CARE, vol. 5, 2015.
@article{7100743,
  abstract     = {Background: In patients with hematological malignancies and acute respiratory failure (ARF), noninvasive ventilation was associated with a decreased mortality in older studies. However, mortality of intubated patients decreased in the last years. In this study, we assess outcomes in those patients according to the initial ventilation strategy. 
Methods: We performed a post hoc analysis of a prospective multicentre study of critically ill hematology patients, in 17 intensive care units in France and Belgium. Patients with hematological malignancies admitted for ARF in 2010 and 2011 and who were not intubated at admission were included in the study. A propensity score-based approach was used to assess the impact of NIV compared to oxygen only on hospital mortality. 
Results: Among 1011 patients admitted to ICU during the study period, 380 met inclusion criteria. Underlying diseases included lymphoid (n = 162, 42.6 %) or myeloid (n = 141, 37.1 %) diseases. ARF etiologies were pulmonary infections (n = 161, 43 %), malignant infiltration (n = 65, 17 %) or cardiac pulmonary edema (n = 40, 10 %). Mechanical ventilation was ultimately needed in 94 (24.7 %) patients, within 3 [2-5] days of ICU admission. Hospital mortality was 32 % (123 deaths). At ICU admission, 142 patients received first-line noninvasive ventilation (NIV), whereas 238 received oxygen only. Fifty-five patients in each group (NIV or oxygen only) were matched according the propensity score. NIV was not associated with decreased hospital mortality [OR 1.5 (0.62-3.65)]. 
Conclusions: In hematology patients with acute respiratory failure, initial treatment with NIV did not improve survival compared to oxygen only.},
  articleno    = {28},
  author       = {Lemiale, Virginie and Resche-Rigon, Matthieu and Mokart, Djamel and Pène, Frederic and Rabbat, Antoine and Kouatchet, Achille and Vincent, François and Bruneel, Fabrice and Nyunga, Martine and Lebert, Christine and Perez, Pierre and Meert, Anne-Pascale and Benoit, Dominique and Chevret, Sylvie and Azoulay, Elie},
  issn         = {2110-5820},
  journal      = {ANNALS OF INTENSIVE CARE},
  keywords     = {Lymphoma,Noninvasive ventilation,Immunosuppression,ICU,PROGNOSTIC-FACTORS,SURVIVAL,CANCER-PATIENTS,PROSPECTIVE MULTICENTER,Leukemia,PROPENSITY SCORE METHODS,ACUTE MYELOID-LEUKEMIA,Mechanical ventilation,INTENSIVE-CARE-UNIT,NONINVASIVE MECHANICAL VENTILATION,RANDOMIZED CONTROLLED-TRIAL,Neutropenia},
  language     = {eng},
  pages        = {9},
  title        = {Acute respiratory failure in patients with hematological malignancies : outcomes according to initial ventilation strategy : a Groupe de recherche respiratoire en réanimation onco-hématologique (Grrr-OH) study},
  url          = {http://dx.doi.org/10.1186/s13613-015-0070-z},
  volume       = {5},
  year         = {2015},
}

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